06-29-2018, 09:29 AM | Community Wiki

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Dementia and Parkinson's

  1. Default Dementia and Parkinson's
    Medical Coding Books
    Hello all,
    I've got a little back and forth going on with an Attending Physician's office regarding a change to a Primary Diagnosis (I am in Hospice). The patient was referred to us with a Primary Dx of Parkinson's and with an Other Dx of Dementia. When I look in the Alphabetical listing I am led to G31.83 Dementia w/Lewy Bodies which INCLUDES Dementia w/Parkinsonism. The Attending is adamant that the Primary Dx remain Parkinson's instead of using the combination code I was led to in the ICD-10 manual. I would like to be able to understand where to go from here...
    Any suggestions or helpful tips would be welcome.
    Thank you!
    Melanie Shannon, CPC-A

  2. #2
    Columbia, MO
    G81 codes need an F02 code added on and G81.83 has an exclude 1 note for G20 and G21, indicating they cannot be coded here. I am uncertain what more you would need.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Clearwater, FL (81334)
    Default Hospice/Parkinson's
    Hi Melanie!

    I also work for a hospice. We've had a problem with the physicians understanding as well. Until your HIM Director addresses these situations, I've found that adding a copy of the section of the guideline that is an issue by using a snipping tool and putting it into my emails helps.

    Wanda J Sutton, CCS, CPC

  4. #4
    Clearwater, FL (81334)
    Default Sequencing Parkinson's w/dementia; Lewybodies
    Quote Originally Posted by mitchellde View Post
    G81 codes need an F02 code added on and G81.83 has an exclude 1 note for G20 and G21, indicating they cannot be coded here. I am uncertain what more you would need.
    I have physicians that document Dementia and Parkinson's, and only sometimes they mention/document Lewybodies. So for both instances it seems G31.83, F02-, G20 would be used, correct?

    Now if it is Parkinson's alone that is documented w/o mention of dementia.... G20 only. F02- would not be used, correct?

    Hope I explained that well enough
    Wanda J Sutton, CCS, CPC

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